THE RISK OF SILENCE: ILLNESS TRAPS PATIENT IN BATTLE FOR SURVIVAL

Doreen Weyland discovered the lump in her left breast three years ago, when she was 31.

Her gynecologist said she was lucky to have detected it herself. He wouldn't have sent her for a baseline mammogram, a breast X-ray, for another four years.Six months of chemotherapy didn't stop the cancer from metastasizing, from spreading to her bone. She had a toxic reaction to chemo and was placed on hormone treatments. Eventually she lost one breast and her ovaries to her disease. She also lost her political innocence."It wasn't a decision at the time of worrying about having kids down the road. It was `I want to live.' It's not just having a little bout with cancer. It's like being in a war."

Her case defies stereotypes. For one thing, she's young. For another, the disease isn't part of her family history.

It's estimated that only one-third of all breast cancers strike women under 50. The American Cancer Society urges women over the age of 40 to have mammograms every one to two years; women over 50 should have one every year.

While researchers believe breast cancer is genetically linked, that didn't hold true in Weyland's case. There's no cancer of any kind in her family. In fact, she didn't even know anyone with the disease.

With early detection, treatment can often halt the cancer's growth. But Weyland's had already spread.

"There isn't anything I do in my life that I don't think about cancer first," she says. "I think about buying a new car and it has a longer warranty that I do. Another five-year loan on a car? No way. I think about putting a deposit on a cruise, and I wonder if I'll be able to go.

"Your mind plays tricks on you. I think, `Should I buy four rolls of toilet paper or one?' "

Going through the emotional roller coaster of menopause at age 31 was traumatic. Her emotions were out of control. She'd have hot flashes at work, find the back of her dress drenched in sweat. At night, she couldn't breathe.

The hormone treatment caused her to gain so much weight that she felt trapped in a stranger's body. "One morning I woke up and I had gained 60 pounds."

Her disease has trapped her in other ways as well. "I am tied to my job. If I have a need to look elsewhere for a job, I am uninsurable. I need the insurance or I don't have treatment."

She has become outspoken because of her disease. She has joined a support group. She urges other breast-cancer patients to find out about their treatment, to question their doctors.

She's mad that legislators didn't pass a bill to create a risk pool for people who might be uninsurable. She's researching bone-marrow treatments, a procedure that is still considered experimental by many insurance companies.

She appreciates the quality of care available in Salt Lake City, but she has become an informed patient so she can be involved in the decisions about her treatment.

She asks her radiologist to teach her how to read her X-rays, and she requests copies of all her reports. "Doctors don't always agree," she said, "and doctors aren't always right.

"When I hear about women who are afraid to get a mammogram, I come unglued. `You could be killing yourself. How could you not want to live?' "

While in the past breast cancer was considered an embarrassing disease, Weyland said patients need to speak out: to demand more money for medical research; to demand risk pools for uninsurables; to demand insurance companies cover new treatments.

She and other breast-cancer patients are writing a book about the disease. The process is taking so long, some are worried that the book will have to be dedicated to some of its authors after they die of a disease that still has no cure.

"By sharing my story, I hope more people get on the bandwagon. They've got to. It's killing too many of us."